Causes of Heel Pain


flat feet cause heel pain


When the plantar fascia—the thick band of tissue that connects the ball and the heel of the foot—becomes  inflamed it can be very uncomfortable as this is what causes plantar fasciitis (heel spurs.)The following conditions can lead to the development of plantar fasciitis and heel spurs:

Fallen Arches/Flat Feet

If you have flat feet your chances of developing plantar fasciitis (heel spurs) increases dramatically, as having an unorthodox foot shape is one of the primary contributing factors of foot pain. People who have flat feet are at increased risk for plantar fasciitis and heel pain because of their tendency to over-pronate. When feet over-pronate it means that the ankle and foot bend in when walking or running. While some ‘rolling in’ of the foot and ankle is normal if the movement becomes exaggerated due to fallen arches (which leads to flat feet) this puts too much stress on the inside stretch of the plantar fascia, which then will often lead to the a case of plantar fasciitis (heel spurs).

High Arches

If having flat feet can cause plantar fasciitis and heel spurs then you might be tempted to think that high arches would be a saving grace, but this is simply not true; any type of unorthodox foot shape can throw the body out of alignment and cause problems.

People with flat feet tend to roll inward too much and people with high arches have the opposite problem—they don’t roll inward enough. When this occurs it is referred to as supination, and it means that when the foot hits the ground when walking or running most of the pressure is absorbed by the outside of the foot alone, which creates an imbalance in the tension of the foot that often causes plantar fasciitis and heel spurs. This situation can also create enough tension in the foot to detach the plantar fascia from the heel bone.

Inflexible and/or Weak Foot Muscles

Weakened or atrophied foot muscles can be a primary factor in cases of plantar fasciitis and heel pain.  If the muscles of the foot are underdeveloped it causes uneven pressure points to develop when walking and/or standing. Having unequal muscle strength in the sides of the foot (when the inside or outside of the foot is stronger than its counterpart) can cause either supination or over-pronation to occur.

If you have limited flexibility in your feet you will not be able to ‘roll through’ each step and thereby equally distribute your body weight over the length of your entire foot. In fact, if you have a stiff or ‘frozen’ big toe this will stunt the flexibility of your front foot and put more pressure on your arch, which will potentially cause you to land more heavily on your heel, all of which can lead to the development of plantar fasciitis (heel spurs.)

Tight Calf Muscles

Studies have shown that if you have tight or inflexible calf muscles then you also have a 23% greater chance of developing plantar fasciitis and heel spurs. Having tight calf muscles more often than not will cause your feet to pronate inward and it will also contribute to repetitive over-stretching of the plantar fascia, none of which is good news as both these conditions lead to chronic inflammation.

Having tight calf muscles can result from sitting down most of the time, which often occurs with desk jobs or jobs that require a lot of driving. When we sit we have a tendency to push the front of the foot into the ground and this places excessive stress on the arch (and therefore the heel) of the foot.

People who stand for excessive amounts of time at their job however, (nurses and waitresses, for example) are also prone to tight calf muscles, plantar fasciitis, and heel spurs simply because of the amount of time that their muscles and tendons are placed under heavy strain. This amount of tension must be released through stretching, rest, or even massage or it can lead to muscles stiffness and imbalances that will lead to inflammation of the plantar fascia and pain in the heel of the foot.

Lack of Physical Exercise

When we are not sufficiently physically active for long periods of time this has a negative effect on the entire body, and it will eventually affect the health of our feet. The muscles of the body can begin to atrophy without exercise (including muscles in the feet), and the effects are two-fold; not only does our musculature have a hard time supporting us but it increases our risk of injury when we do become more active, which means that the solution to this problem can become a problem if we’re not careful.

And it doesn’t have to be a sport or a training session that causes us to be active on short notice; pushing a stalled car to the side of the road is a common cause of injury as is suddenly pushing off of the front of the foot to catch a falling child. Sufficient muscle tone and muscle health is absolutely necessary in the prevention of plantar fasciitis and heel pain.

Weight Gain and/or Obesity

If you are overweight, obese, or have recently gained excessive pounds this sharply increases the amount of tension that the joints, muscles and tendons in your back, legs, and feet must cope with. Our bodies were not meant to carry excessive fat and doing so actually lowers our centre of gravity, which in turn causes serious muscles strain.

Sports Training

Being physically active is one of the most important choices you can make for your health, but the more active you are the greater the chances are of being injured. And while there is no question that it is well worth the risk you have to make sure that you’re not inadvertently putting yourself in harm’s way as well. For instance, if you’re running, participating in aerobics classes, or playing volleyball make sure that you’ve got the proper footwear for the activity and that you’re not training on overly hard, unforgiving surfaces.

You also need to make sure that you stretch enough and apply ice to inflammation as it occurs as many sports are repetitive and require the foot to repeatedly strike the ground for long periods of time, which can lead to chronic problems or acute injuries in the leg and foot.


The correct way to lift a heavy item from the ground is to use the squat position and transfer most of the weight to the legs instead of the back. This is a great way to avoid injury unless you’re transferring all of that weight to the front of the foot as you stand.  This type of tension transfer to the front of the foot also frequently occurs in delivery drivers who must repeatedly step up into their trucks, but this can not only cause plantar fasciitis and heel spurs it can also cause the plantar fascia to tear away from the heel of the foot.

The best way to avoid this type of injury is to push off from your heels when lifting something heavy, rising from the squat position for any reason, and when climbing the stairs. This last part is particularly true if you must climb steps regularly or if you already have inflammation issues with your plantar fascia. Any movement that requires you to push off from the front of your foot increases the chance that you will develop plantar fasciitis and heel spurs, especially if the movement is repetitive, so be mindful of how you’re using your feet under these circumstances.

Acute Injury

Acute injuries occur from one traumatic event instead of the general wear and tear that can occur over time or result from activities that require repetitive motions. It happens on occasion that the plantar fascia becomes completely detached from the heel bone; this most often occurs when the body suddenly lunges forward or when a sprint is initiated from a standing position (as opposed the body already being in motion.) When this kind of injury occurs it is often accompanied by a ‘popping’ sensation or sound, and it usually indicates a plantar fascial rupture. You are at increased risk of experiencing one of these ruptures if you already have plantar fasciitis or heel spurs, but ruptures can also cause inflammation and heel pain where it didn’t exist before.

A ruptured plantar fascia can lead to fallen arches and flat feet which can cause of aggravate planter fasciitis and heel spurs if proper treatments are not applied. This type of injury usually occurs in sports such as rugby or tennis due to the speed and frequency of lateral and forward motion that these activities require.

Chronic Injury

General foot and heel pain, particularly the ‘bruised’ feeling and sensations of tightness or ‘pulling’ in the arch can creep up on you over time. Chronic injuries do not usually announce themselves with a popping sound or sensation and sufferers may be unable to pinpoint the exact cause of their injury. But just because chronic injuries are the result of a slow build and not a single event it does not make them any less painful. It can actually make them slightly more dangerous because if they’re not caught in time blood vessel damage in the afflicted area can occur and run interference in healing process, which means that individuals may have to deal with the pain of plantar fasciitis and heel spurs for longer than they wanted to.


Inappropriate footwear is a major contributor in the development of plantar fasciitis (heel spurs). If you choose to wear shoes that do not have proper arch support or enough cushioning at the heel; if you wear shoes with a high heel, or shoes that are too rigid at the toe and too flexible in the middle then you are at increased risk of developing foot pain. Updating your sneakers after three months of heavy use is also recommended because training in shoes that have seen better days will not give your feet the stability, protection, and cushioning they need. It’s also important that you choose sneakers that fit well, are not too tight, and have proper structure and balance for the activities that you are performing.

And while wearing high heels can cause many problems on its own switching between this type of shoe and a flat shoe wreaks havoc on your calf muscles, so care must be taken when switching back and forth between different styles of foot wear.

Your Centre of Gravity

If your centre of gravity is lower than it should be, or if it has shifted has due to changes in the body such as weight gain or pregnancy this creates imbalances in the body that places excessive strain on the arches of the feet, which over the long term leads to plantar fasciitis (heel spurs).  Acquiring or maintaining a healthy weight is an important factor in your overall health, but it is a crucial factor in preventing or treating foot and heel pain.

Improperly Fitting Orthotics

Foot pain that feels very similar to the discomfort causes by plantar fasciitis (heel spurs) can be caused by improperly fitting orthotics. Just as it may take time to ‘break in’ a new pair of shoes so it is with new orthotics as well. It’s best to start slowly when working in a new device;  wear your new orthotic for 30 to 45 minutes a day for about a week,  gradually increasing the amount of time you wear them until they shape to your foot and shoe and you’re no longer aware that they are there.

If you have a device that really does not conform to the shape of your foot however, no amount of breaking it in will help you feel comfortable.  An improperly fitting orthotic will cause nothing but more pain and foot problems so you should consult your doctor or podiatrist on the matter as soon as possible.

While poorly fitting orthotics may not be a major cause of plantar fasciitis (heel spurs) this situation will not only cause you pain but it may make your situation worse as well.


Like improperly fitting orthotics, sciatica does not directly cause planter fasciitis or heel spurs but it’s on this list because the symptoms can be confusingly similar. Pressure on the sciatic nerve causes lower back pain that can not only travel into the buttocks and upper leg, but it can continue to travel into the calf muscle, the side of the foot, and the heel. If you think you may have plantar fasciitis but you also have pain in the lower back or upper legs then it’s best to have your doctor check for sciatica as these symptoms are not usually associated with plantar fasciitis and heel spurs.


Because there are several causes of plantar fasciitis (heel spurs)  it is not always possible to pinpoint which one has caused the issue to arise, but hopefully this list can give you a better idea of what activities or events may be causing your foot pain to occur. Diagnosis and treatment of foot pain should be overseen by your doctor, but if you can narrow down the potential causes of your discomfort this may help speed up your recovery and help you to prevent a reoccurrence of this uncomfortable condition in the future.

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